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Massage Today
April, 2015, Vol. 15, Issue 04

Become Prepared for the Path to Healthcare Integration

By Eric Polgar, AFMTE Board of Director and Stan Dawson, AFMTE Board of Director

Einstein said insanity is doing the same thing over and over again and expecting different results. Blindly continuing to follow the current healthcare system is insane based on the mediocre outcomes and high costs of health care in the U.S. The current American health system does not actually create the health and wellness Americans deserve.

Growing numbers of healthcare leaders and legislators recognize the need for change. The Patient Protection and Affordable Care Act (ACA) has set forth a solution that affects almost every American. Under the ACA, the massage therapy profession is positioned to make a major difference in the health and wellness of all Americans.

Health care costs represent an economic challenge to this nation that rivals the overall national debt and annual deficits. Health care in the U.S. costs twice as much per person as health care in Japan, England, or Canada. According to the U.S. budget, America spent 18% of its GDP on health care in 2010, while the Organization for Economic Cooperation and Development reported the second largest spender (France) spent 11%.

For all this spending, one would think health outcomes in the U.S. would be the best in the world. This is not the case. In 2010, the World Health Organization ranked the U.S. 37th out of 191 nations. Although the U.S. was in the top 20%, it is actually near the bottom of the list for developed nations. Americans are not getting the results they are paying for. What accounts for the discrepancy between cost and outcomes?

healthcare - Copyright – Stock Photo / Register Mark Common sense says the healthcare system should be more focused on prevention, wellness and better health outcomes, and using safe, low-cost options for treatment first and riskier more expensive options for treatment later, unless a compelling medical emergency exists. Greater emphasis should be placed on listening to the client/patient and managing the quality of their overall experience.

What Massage Therapists Can Do

Massage therapists already focus on prevention and wellness. They provide safe, low-cost care, and create a person-centered therapeutic relationship. Philosophically, clinically, and economically, massage therapists are well positioned to make a difference in the cost of health care, health outcomes, and patient experience. New generations of massage therapists need to be able to work in teams with conventional health care practitioners, as well as other CAM practitioners. Fortunately, the Affordable Care Act calls for a focus on wellness and prevention. The non-discrimination clause in the ACA calls for equal acceptance of all licensed healthcare professionals acting within their scope of practice.

With the right strategy, the massage profession can not only make a major contribution, but a growing contribution to the future management of U.S. healthcare costs, health outcomes and the quality of the experience of healthcare consumers. The ACA has placed a new emphasis on prevention, wellness, and rehabilitation which makes massage just what the doctor ordered. Licensed massage and bodywork professionals have a tremendous opportunity.

Looking at the landscape, massage is an emerging healthcare profession, poised to support and promote the health and wellness of all Americans. In 2013, massage therapy was estimated to be an $8 billion per year industry, but only 16% of the adult population received a massage. With more than 250,000 providers in the United States, massage can hold tremendous influence on health outcomes and health policy. To meet the needs of more than 16% of the public, massage probably needs more numbers of full-time practitioners.

The Recent Past

Massage has gained acceptance from both policy makers and healthcare professionals. In 2002, The White House Commission on Complementary and Alternative Medicine Policy found that massage was one of the most popular CAM practices in cancer care, insomnia, depression and anxiety. The National Institute of Health released statistics on CAM use for 2007 and massage was still one of the most utilized practitioner based CAM services.

While some wonder whether massage is truly a healthcare profession, a vast majority of consumers and practitioners believe massage is health care and some states have classified massage, in law, as a healthcare profession. Massage has gained acceptance and is used in hospitals, rehabilitation centers, chiropractic offices, VA centers, training rooms, gyms and spas. In short, massage is maturing as a healthcare profession and has established a basis for a bright future.

Recently, the massage profession has been refining its infrastructure by creating a Model Practice Act, a set of entry-level standards (ELAP), the unification of the licensing exams, and the Core Competencies for Massage Therapy Teachers. Many emerging healthcare fields are envious of what has been accomplished in massage therapy. Successful collaboration has occurred on a national level, even while organizations pursue their own agendas. Yes, the future looks bright, but are we ready?


In order to be ready for the emerging opportunity, changes need to be made to the current massage education system. Massage needs better educational standards, opportunities for schools to be recognized for excellence in addition to full accreditation that creates more consistency in massage education, qualified instructors, and a better post-graduate educational program, including speciality certifications.

According to Martha Menard Brown, seventy-five percent of massage educators stated the current quality of massage education is inconsistent, with only 10% of massage educators agreeing that current educational quality is adequate. Massage therapists need to be taught a variety of techniques and methods to treat clients, which is health care regardless of where the treatment is delivered. Education is the foundation of every healthcare profession. One certainty is the massage profession needs to continue focusing on ethics, professionalism, and needs to include the delivery of integrative healthcare in entry-level programs. The massage and bodywork education sector needs refinement in order to prepare future generations of massage therapists to work in the emerging healthcare system.


The main challenge to the advancement of the massage profession is the perception of massage by the public and by other healthcare providers. Critics of massage currently perceive the profession as lacking unity, high educational standards, and scientifically rigorous research to support the work. Critics also point to the spiritual and energetic components of massage, saying there is no place for these concepts in health care. With a different perception, massage would be better utilized by the public and better integrated with other healthcare providers. The question becomes: How do we change perceptions?

Bright Future

The Alliance Board of Directors thinks there are three pillars to support a new perception of massage: quality massage education; a sound research and evidence base showing cost effectiveness, improved health outcomes, and better patient experience; and a broad national marketing campaign focused on the health benefits of massage.

With good planning and smart choices, massage therapists have the opportunity to help millions of people manage stress, prevent illness, and rehabilitate from disease and injury, thereby improving day to day function and participation in life activities. Each stakeholder group is already engaged in refining the profession. Parallel to these ongoing projects, the profession as a whole must also focus on the three pillars.

The Alliance for Massage Therapy Education has an ongoing National Teacher Education Standards Project to identify competency standards for teachers. In the next couple of years, the Alliance will complete a curriculum for training massage therapy and bodywork educators. This will lead to a certification program for massage educators. Quality teachers and the education and experience they pass on will benefit the entire industry, as well as massage and bodywork consumers.

Massage has already been shown to substantially help four of the ten essential health benefits specified in the ACA, including services in:

  • Ambulatory care.
  • Mental health/substance abuse.
  • Rehabilitation/preventive/wellness.
  • Chronic disease management.

Future research in the massage profession should focus on the triple aim goals, as well as identifying the underlying processes that create the benefits of massage. To encourage the development of new perceptions of massage therapy by the public and other healthcare providers, the professional groups, corporate partners, and private practitioners will need to work together to effectively market the benefits of massage to consumers, healthcare providers, and policy makers.

In 2015, The Alliance for Massage Therapy Education (AFMTE) and The Commission for Massage Therapy Accreditation (COMTA) will co-host the 2015 Educational Congress (July 21-28 in Minneapolis) where several professional groups including the ABMP, MTF, FSMTB, NCBTMB, AMTA, AOBTA, and S4OM, will discuss the future of massage therapy. Expect a lively discussion on the future of massage. If massage is going to have the future described here, the planning starts now.

For more information about the Educational Congress, visit


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